This project will identify assumptions and ideologies surrounding health care reform and then devise communication and outreach strategies for policymakers to use when discussing coverage expansion policies. This work aims to show that local and national leaders can communicate in ways that enhance public health responses, reduce racism and xenophobia, and promote shared responsibility. To do this, the project team will: 1) Explore people’s attitudes and beliefs through 32 focus groups to be conducted in Kentucky and Tennessee using an interview guide adapted from the research team’s prior work. The questions will assess participants’ basic knowledge and attitudes about health care and public health as well as their values and beliefs, racial resentment, and information sources. In each state, focus groups will be stratified as follows: Black, white, and Latinx adults with low income, and Black, white, and Latinx adults with middle income. For Tennessee, investigators also will explore how attitudes and beliefs may have changed over the past decade. 2) Analyze local and national media, social media, and political rhetoric overall surrounding public health and health care during the pandemic, with the aim of contextualizing and understanding what drives attitudes and beliefs. 3) Pilot a communication and messaging campaign with the Tennessee-based media organization Millions of Conversations. This will draw upon themes from the focus groups and contextual analyses to build broader consensus for proposed reforms.